C反应蛋白和白细胞介素6在胃癌诊断和预后中的意义

The Significance of C Reactive Protein and Interleukin-6 in Diagnosis and Prognosis of Gastric Cancer

目的探讨C反应蛋白(CRP)和白细胞介素6(IL-6)在胃癌诊断和预后中的意义。方法选择本院就诊胃癌患者80例纳入研究组,同期体检的健康成年人80例纳入对照组。血清癌胚抗原(CEA)、IL-6和糖类抗原(CA19-9)测定采用酶联免疫法,CRP测定采用免疫比浊法,比较两组之间CEA、IL-6、CA19-9和CRP差异。结果胃癌患者血清CEA、IL-6、CRP和CA19-9水平均显著高于健康对照组(P<0.05)。血清CEA、IL-6和CA19-9水平与淋巴结转移相关,而CRP与肿瘤分期、胃壁浸润、淋巴结转移和远处转移相关。IL-6诊断胃癌的敏感性高于CRP、CEA和CA19-9。此外,IL-6与CRP和CEA三者联合的敏感性显著增高。IL-6的ROC曲线下面积比CEA、CRP和CA19-9高。结论血清CEA和CA19-9是影响患者生存率的重要因素,但IL-6、CEA、CRP及CA19-9不是胃癌患者生存的独立预后因素。IL-6与CRP结合诊断胃癌优于CEA和CA19-9。

Objective To investigate the significance of serum C-reactive protein（CRP） and interleukin 6（IL- 6） in the diagnosis and prognosis of gastric cancer. Methods Eighty patients with gastric cancer as study group and 80 healthy persons as control group were enrolled in this study. Serum levels of IL-6, carcinoembryonic antigen （CEA） and carbohydrate antigen（CA19-9） were determined by enzyme-linked immunosorbent,CRP was determined by immunoturbidimetric assay. Results In the study group, serum concentrations of IL-6,CEA,CRP and CA19-9 were significantly higher than those in the control group. Serum levels of IL-6,CEA and CA19-9 were related with lymph node metastasis, and CRP was associated with tumor stage, gastric wall infiltration, lymph node metastasis and distant metastasis. Diagnostic sensitivity of IL-6 for gastric cancer was higher than that of CRP,CEA and CA19- 9. In addition, diagnostic sensitivity of IL-6 jointly with CRP and CEA were significantly higher than others. Diagnostic specificity and positive predictive value of CRP are slightly lower than those of the CEA and CA19-9. The negative predictive value of CRP was higher than that of the CA 19-9 and CEA. The area under the ROC curve of IL- 6 was higher than that of CRP,CEA and CA 19-9. Conclusions CEA and CA19-9 are important factors for survival of patients,but IL-6,CEA, CRP and CA19-9 are not independent prognostic factors for survival of patients. Better usefulness of combined serum IL-6 and CRP is proven compared to combined serum CEA and CA19-9 in the diagnosis of gastric cancer.